Case Manager Nurse - USRN

Qualifications:

• Graduate of BS Nursing, USRN required.
• At least 1 year previous hospital nursing experience or Case Management experience in a clinical setting for a US-based healthcare company, required.
• Experience in Prior Authorization, Case Management and Utilization Review

Experience:

• Prior Authorization: 1 year (Preferred)
• Case Management: 1 year (Preferred)
• Utilization Review: 1 year (Preferred)

Full job description

The Case Manager Nurse will regularly liaise with multiple clinical specialties and doctors. This role also involves consistent interactions with insurance providers, patients and their families, legal delegates, and representatives from other medical care institutions. Additionally, they will often communicate with nursing staff, billing teams, medical social workers, and personnel from various departments.